CAVERNOUS HAEMANGIOMA IN THE GASTROCNEMIUS MUSCLE: A RARE PRESENTATION IN THE GERIATRIC AGE GROUP
Intramuscular haemangiomas are believed to be hamartomatous and are a distinctive type of haemangioma occurring within skeletal muscle. They account for less than 1% of all haemangiomas. They occur more often in trunk and extremity muscles.
A sixty five year old lady presented with swelling and pain from the back of the left knee for two years.
On clinical examination, a mass of about 10X10 cms in size was noted in the left popliteal fossa. The swelling was tender with well defined borders but fixed to the muscle. She had a flexion deformity of knee of ten degrees.
MRI revealed a large encapsulated cystic lesion in the posterior aspect of the muscular compartment of the knee.
She underwent excision of the mass, intraoperatively the mass was noted to be arising from the gastrocnemius. Histopathology revealed large cavernous filled spaces filled with blood which indicated a cavernous haemangioma.
Most of the literature suggest the occurance of capillary haemangioma to be a commoner one. Occurance of a cavernous haemangioma is usually before the third decade and is congenital in most times. Most of the authors emphasize that radiological methods are generally insufficient for the correct diagnosis of intramuscular hemangiomas, and surgery is the treatment of choice to exclude malignancy and for adequate treatment of these lesions.
Hence, the present case which we are reporting here is a rare occurance of a cavernous haemangioma of the gastrocnemius in a 65 year old lady, which was managed by surgical methods.
Keywordscavernous haemangioma - gastrocnemius - popliteal fossa - intramuscular haemangiomas - blood filled spaces
26 April 2020 (online)
Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India
- 1 T Bucci, F De Giulio, A Romano, L Insabato, and L Califano. Cavernous haemangioma of the temporalis muscle: case report and review of the literature. Acta Otorhinolaryngol Ital. 2008 April; 28(2): 83–86.
- 2 Orthoinfo.aaos.org/topic.cfm?topic=A00630.
- 3 AllanPW, EnzingerFM. Haemangiomaofskeletalmuscle: ananalysisof 89 cases. Cancer 1972;29:8–22.
- 4 WatsonWL, McCarthyWD. Bloodandlymphvesseltumors. Areportof 1056 cases. Surg Gynecol Obstet 1940;71:569–88.
- 5 Ferguson ILC. Haemangiomata of skeletal muscle. Br J Surg 1972;59- 8:634–7.
- 6 Jones KG. Cavernoushaemangiomaofstriatedmuscle areviewofliterature and are port off our cases. J Bone Joint Surg 1953;35A:717–28.
- 7 Mencke HJ, ZilkensJ, BigalkeKH, AmmonJ. The problem of intramuscular haemangioma. Arch Orthop Trauma Surg 1982;100:243–7.
- 8 BehamAJ,Fletcher CDM. Intramuscular angioma: a clinicopathologic analysis of 74cases. Histopathology 1991;18:53–9.
- 9 Mulliken J B,G LowackiJ. Haemangiomas and vascular malformations in infants and children: a classification based on endothelial characteristics. Plast Reconstr Surg 1982;69:412–22.
- 10 Hassanein AH, Mulliken JB, Fishman SJ, Greene AK. Evaluation of terminology for vascular anomalies in current literature. Plast Reconstr Surg 2011;127(1):347–51.
- 11 Fernandez-Pineda I. Intramuscular cavernous haemangioma. Am J Surg 2009;198(2):300–1.
- 12 HeinKD, Mulliken JB, Kozakewich HP, Upton J, Burrows PE. Venous malformations of skeletal muscle. Plast Reconstr Surg 2002;110:1625–35. 11.
- 13 BuetowPC, Kransdorf MJ, MoserJrRP, Jelinek JS, Berrey BH.Radiographic appearance ofintramuscularhemangiomawithemphasison MRimaging. Am J Roentgenol 1990;154:563–7.
- 14 ChristensonJT, GunterbergB. Intramuscularhaemangiomao ftheextremities: is computerizedtomographyuseful? Br J Surg 1985;72:748–50.
- 15 Hristov N, Atanasov Z, Zafirovski G, Mitrev Z. Intramuscular cavernous hemangioma in the left soleus muscle: successful surgical treatment. Interact Cardiovasc Thorac Surg. 2011 Nov;13(5):521-2.
- 16 Dong Hwee Kim, Miriam Hwang, Yoon Kyoo Kang, In Jong Kim and Yoon Kun Park. J Korean Med Sci. 2007 June; 22(3): 580–582.